Q: 'Phlegmasia cerulea dolens' happens in

A) Deep Venous Thrombosis (DVT)
B) Septic shock
C) Severe Vasoplegia
D) Cholesterol Emboli
E) Diabetic toe


Answer: A

'Phlegmasia cerulea dolens' translates to 'painful blue edema' and is a hallmark of a severe form of DVT which results from extensive thrombotic occlusion of the major and the collateral veins of an extremity. It is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. It carries extremely high risk of  massive pulmonary embolism (PE) even though anticoagulation is given. Therefore, invasive vascular intervention is needed. Beneath  this, underlying disease process like Heparin Induced Thrombocytopenia (HIT) or malignancy is always a fear.


References:

1. Sarwar S, Narra S, Munir A. Phlegmasia cerulea dolens. Tex Heart Inst J 2009; 36:76.

2. Barham, Kalleen; Tina Shah (2007-01-18). "Images in Clinical Medicine: Phlegmasia Cerulea Dolens". The New England Journal of Medicine. 356 (3): e3.